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26 Cards in this Set
- Front
- Back
EPO produced in
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Interstitial Peritubular Cells
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Renin produced in
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Juxtaglomurelar Apparatus
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Cause of EPO secretion
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Renal Hypoxia
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Causes of Renin secretion (3)
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Na level variation
Sympathetic Stimulation Fall in efferent art pressure |
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By inhibiting ACE what two effects do we prevent(2)
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we prevent:
Production of Angiotensin II (reducing vasoconstriction) Bradykinin breakdown (thus vasodilating) |
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The left kidney is usually higher than the right
T/F |
True
the liver pushes the right one down a bit |
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% of cardiac output down renal arteries
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20 - 25%
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Detrusor contraction innervation
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Parasympathetic from S2-4
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Innervation for
Detrusor relaxation + Bladder neck contraction |
Sympathetic from T10-L2
(a-adrenoreceptors) |
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Distal Sphincter innervation
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Somatic nerves (Pudendal) S2-4
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Urea Normal range
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2.5 - 6.6 mmol/L
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Causes of Hyperuraemia >6.6 (3 groups)
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Intake (GI Haemorrhage, High protein diet,)
Production (Trauma, burns, serious infection) Reduced excretion (Hypovolaemia (inc reabsorption), Renal Failure) |
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Causes of Hypouraemia <2.5 (3 groups)
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Low intake (malnutrition, anorexia)
Low production (liver failure) Inc excretion (high urine flow) |
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Creatinine Normal Range
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60-120 umol/L
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Causes of Raised Creatinine >120
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High production (Rhabdomyolysis, Large Muscle Mass)
Reduced Excretion (Renal Failure, Tubular secretion competition - eg trimethoprim) |
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Causes of Low Creatinine <60
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Small Muscle Mass
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Which is a more reliable indicator of renal function...
Serum urea or Serum creatinine |
Serum Creatinine
Serum urea is affected by lots of variables including protein intake, liver metabolism, etc. Creatinine is released at an almost constant rate from muscle mass and almost completely secreted at the glomerulus. However serum creatinine only falls below normal low of 60 when GFR is reduced by at least 50% and can be misleading when muscle mass is small or large. |
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GFR normal range
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95 - 145 ml/min/1.73m2
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Nephritic Syndrome is (4)
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Haematuria (brown urine)
Oedema and generalised fluid retention Hypertension Oliguria |
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Nephrotic Syndrome is
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Overt proteinuria-usually > 3.5 g/24 hrs (urine may be frothy)
Hypoalbuminaemia (< 30 g/l) Oedema and generalised fluid retention Intravascular volume depletion with hypotension, or expansion with hypertension, may occur |
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Acute presentation triad of pyelonephritis
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Fever
Tenderness over kidneys Loin pain |
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Rare complication of acute pyelonephritis
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Papillary necrosis
in which renal papillary tissue can fragment off and cause obstruction or examined on histology from urine |
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Kidney Stone composites (3)
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Calcium 80%
Ammonium Phosphate 15% Cytstine or Uric Acid (rare) |
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Risk factors Kidney Stones
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Environmental - heat (low urine volumes)
Dietery - high protein, high sodium, low calcium |
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Investigations for kidney stone
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Abdo XR (90%)
IV Urogram (delayed flow, dilated above stone) Spiral CT |
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Rx Kidney stones
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Morphine (10-20mg)
Advise Drink >2L/day <4mm - bed rest, 90% spontaneous pass >6mm - 10% spontaneous so ESWL (extracorporeal shock wave lithotripsy) |